Poster 238: No Difference in Clinical Outcomes between Operative and Nonoperative Management of Minimally Retracted Proximal Hamstring Ruptures: A Matched Cohort Study

Objectives: The optimal treatment protocol for proximal hamstring ruptures, particularly when involving less than 3 cm of retraction, is not known. The purpose of this study was to compare patient-reported outcomes (PROs) between patients who underwent operative or non-operative management of proximal hamstring ruptures. Methods: A retrospective review of the electronic medical record identified all patients who were treated operatively or non-operatively for a proximal hamstring rupture from 2013 to 2020. Patients were stratified into two groups which were matched based on demographics including age, gender, BMI, chronicity of the injury, tendon retraction, and injury grade (complete, or three tendons, versus partial, or one or two tendons). All patients completed a battery of PROs including the Perth Hamstring Assessment Tool (PHAT), Modified Harris Hip Score (MHHS), Visual Analogue Scale for pain (VAS), and the Tegner Activity Scale. Patients from the non-surgical group were then case-matched in 2:1 fashion to their surgical counterparts. Results: Overall, 113 patients met inclusion criteria and were available for follow-up. Of the 113, 59 (52.2%) underwent primary hamstring tendon repair and 54 (47.8%) patients underwent non-operative treatment consisting of physical therapy. These 54 patients were case-matched to 28 surgically managed patients. When controlling for patient demographics, there were no differences in patient reported outcomes between non-operative and operative treatment of proximal hamstring in any validated outcome indicator (p > 0.05). Chronicity of the injury and older age correlated significantly to worse outcomes in both groups (p < 0.05). Conclusions: In patients with proximal hamstring ruptures with <3 cm of retraction, there was no difference in PRO scores between matched cohorts of operatively and non-operatively treated proximal hamstring avulsions